Feasibility of radiotherapy or chemoradiotherapy after taxane-based induction chemotherapy for nonoperated locally advanced head and neck squamous cell carcinomas.

Details

Serval ID
serval:BIB_9E0ACFD8EED0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Feasibility of radiotherapy or chemoradiotherapy after taxane-based induction chemotherapy for nonoperated locally advanced head and neck squamous cell carcinomas.
Journal
Anti-cancer Drugs
Author(s)
Levy A., Blanchard P., Bellefqih S., Brahimi N., Guigay J., Janot F., Temam S., Daly-Schveitzer N., Bourhis J., Tao Y.
ISSN
1473-5741 (Electronic)
ISSN-L
0959-4973
Publication state
Published
Issued date
2014
Peer-reviewed
Oui
Volume
25
Number
10
Pages
1220-1226
Language
english
Notes
Publication types: Clinical Trial ; Journal Article
Publication Status: ppublish
Abstract
To assess the use of radiotherapy (RT) or concurrent chemoradiotherapy (CRT) following taxane-based induction chemotherapy (T-ICT) in locally advanced head and neck squamous cell carcinoma (LAHNSCC) and to evaluate the tolerability of CRT after T-ICT. From 01/2006 to 08/2012, 173 LAHNSCC patients treated as a curative intent by T-ICT, followed by definitive RT/CRT were included in this analysis. There was an 86% objective response (OR) after ICT among 154 evaluable patients. Forty-four patients received less than three cycles (25%) and 20 received only one cycle of T-ICT. The 3-year actuarial overall survival (OS) was 49% and there was no OS difference according to the type of ICT (regimen or number of cycle) or the addition of concurrent CT (cisplatin, carboplatin, or cetuximab) to RT. In multivariate analysis (MVA), clinically involved lymph node (cN+), age more than 60 years, the absence of OR after ICT, and performance status of at least 1 predicted for a decreased OS, with hazard ratios (HR) of 2.8, 2.2, 2.1, and 2, respectively. The 3-year actuarial locoregional control (LRC) and distant control (DC) rates were 52 and 73%, respectively. In MVA, the absence of OR after ICT (HR: 3.2), cN+ (HR: 3), and age more than 60 years (HR: 1.7) were prognostic for a lower LRC whereas cN+ (HR: 4.2) and carboplatin-based T-ICT (HR: 2.9) were prognostic for a lower DC. The number of cycles (≤ 2) received during ICT was borderline significant for DC in the MVA (P=0.08). Among patients receiving less than or equal to three cycles of ICT, higher outcomes were observed in patients who received cisplatin-based T-ICT (vs. carboplatin-based T-ICT) or subsequent CRT (vs. RT). T-ICT in our experience, followed by RT or CRT, raises several questions on the role and type of induction, and the efficacy of CRT over RT. The role of RT or CRT following induction, although feasible in these advanced patients, awaits answers from randomized trials.
Keywords
Adult, Aged, Antineoplastic Agents/therapeutic use, Bridged Compounds/therapeutic use, Carboplatin/therapeutic use, Carcinoma, Squamous Cell/drug therapy, Carcinoma, Squamous Cell/radiotherapy, Cetuximab/therapeutic use, Chemoradiotherapy, Cisplatin/therapeutic use, Disease-Free Survival, Feasibility Studies, Female, Head and Neck Neoplasms/drug therapy, Head and Neck Neoplasms/radiotherapy, Humans, Induction Chemotherapy, Male, Middle Aged, Neoplasm Recurrence, Local, Taxoids/therapeutic use, Young Adult
Pubmed
Web of science
Create date
13/11/2014 18:26
Last modification date
20/08/2019 15:04
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